臺灣博碩士論文加值系統

本研究目的為探討：（一）護理人員對於病人飲酒問題的臨床實務現況；(二) 護理人員對於病人飲酒問題臨床實務之自信、責任、信念及知識；及（三）護理人員其基本屬性、個人經驗、自信、責任、信念及知識對於病人飲酒問題臨床實務的影響。採橫斷式研究設計，以立意取樣選取中部一家區域教學醫院及南部一家醫學中心進行收案。採調查法，使用問卷收集資料，符合收案之護理人員條件為：（1）年滿18歲，領有護士或護理師證書者，(2)目前從事護理臨床工作之護理人員，及（3）願意參與研究及填寫問卷者，共收案172名。結果顯示護理人員對飲酒問題的臨床實務量表平均得分為23.75分(SD=4.39)介於中等，自信量表平均得分為23.22分(SD=4.95)，責任量表平均得分為20.84分(SD=5.22)，信念量表平均得分為45.58分(SD=7.92)及知識量表得分百分率為37.75%均偏低。其中基本屬性的工作科別對飲酒問題臨床實務呈現顯著差異(χ2=22.82,p<0.05)，護理人員的自信(r=.57,p<0.01)、責任(r=.61,p<0.01)及信念(r=.18,p=0.02)與其執行飲酒問題臨床實務呈現顯著正相關。最後利用階層多元迴歸模式強迫進入法將基本屬性、個人經驗及自信、責任、信念及知識等變項放入迴歸方程式發現共可解釋58%臨床實務的變異量，其中工作科別(腸胃科β=.22,t=2.98, p<0.01,精神科β=.14,t=1.73, p<0.01)、自信(β=.44,t=5.97, p<0.01)及責任(β=.33,t=4.00, p<0.01)為護理人員對於病人飲酒問題臨床實務的預測因子。由於本研究結果發現護理人員較少常規執行照護飲酒問題病人的評估、篩檢、建議及轉介，且急診的護理人員對於飲酒問題病人的臨床實務較精神科及腸胃科護理人員少，故建議未來護理人員學習飲酒問題照護的在職教育訓練，可依不同的工作科別設計課程內容；而自信及責任也是影響護理人員對飲酒問題的臨床實務之要素，故可藉由飲酒問題教育訓練課程，以增加護理人員對於病人飲酒問題的自信及責任。

The aims of this study were to explore：(1) nurses’ practices for patients’ alcohol problems, (2) nurses’ confidence, responsibility, belief and knowledge about their practices for patients’ alcohol problems, and (3) the impact of nurses’ characteristics, personal experiences, confidence, responsibility, belief and knowledge on their practices for patients’ alcohol problems. Cross-sectional design was adopted using purpose sampling technique and a regional hospital in central Taiwan and a medical center in southern Taiwan were used as study sites. A survey was performed for the study and a questionnaire was designed to collect the necessary data. Nurses who fulfilled the following criteria were enrolled: (1) aged 18 years old or above with registered professional nurse certificate, (2) working in clinical practice, and (3) willing to join the research and complete the questionnaire. A total of 172 nurses were participated in this study. The mean score of nurses’ practices for alcohol problems was an intermediate score of 23.75 (SD=4.39). All of the other scores were low: the mean score of nurses’ confidence for alcohol problems was 23.22 (SD=4.95); the mean score of nurses’ responsibility for alcohol problems was 20.84 (SD=5.22); the mean score of nurses’ belief for alcohol problems was 45.58 (SD=7.92) and the correct rate of nurses’ knowledge for alcohol problems was 37.75%. Their practices for alcohol problems scores were significantly differed by work unit (χ2=22.82, p<0.05). In addition, nurses’ confidence (r=.57, p<0.01), responsibility (r=.61, p<0.01) and belief (r=.18, p=0.02) were significantly and positively correlated with the nurses’ practices for alcohol problems. Finally, a hierarchical multiple regression was conducted to by entering nurses’ characteristics, personal experiences and confidence, responsibility, belief and knowledge. These variables were found to contribute to 58% of the variation of nursing practices for patients’ alcohol problems, while work unit (gastroenterology medical unit, β=.22, t=2.98, p<0.01; psychology medical unit, β=.14, t=1.73, p<0.01), confidence (β=.44, t=5.97, p<0.01) and responsibility (β=.33, t=4.00, p<0.01) can be used as predicting factors. The study results showed that few assessments, screening and referral of routine care for alcohol problems were performed by nurses. Moreover, nurses who worked in the emergency ward had fewer practices for patients’ alcohol problems than who worked in the psychology and gastroenterology medical units. Therefore, the author suggests that different unit shall have different alcohol in-serve education for nurses. In addition, nurses’ confidence and responsibility were significant predictors of their practice for alcohol problem. There two factors may be increased through education and training courses.

指導教授推薦書..........................................
口試委員會審定書........................................
授權書..................................................Ⅲ
誌謝....................................................Ⅳ
中文摘要................................................Ⅴ
英文摘要................................................Ⅶ
目錄....................................................Ⅸ
表目錄..................................................XI
第一章 緒論............................................1
第一節 研究動機及重要性............................1
第二節 研究目的....................................2
第二章 文獻探討.......................................4
第一節 酒精........................................4
第二節 酒精篩檢....................................7
第三節 護理人員執行病人飲酒問題的臨床實務..........9
第四節 護理人員基本屬性、個人經驗、自信、責任、信
念及知識對於病人飲酒問題之臨床實務的影響...13
第五節 總結.......................................17
第三章 研究架構、問題及名詞解釋.......................20
第一節 概念架構....................................20
第二節 名詞界定....................................20
第四章 研究方法.......................................22
第一節 研究場所及對象..............................22
第二節 研究工具....................................22
第三節 研究過程....................................24
第四節 資料分析....................................24
第五章 研究結果.......................................25
第一節 護理人員基本屬性及個人經驗..................25
第二節 護理人員對於病人飲酒問題的臨床實務..........26
第三節 護理人員對於病人飲酒問題的自信、責任、信念
及知識......................................26
第四節 基本屬性、個人經驗、自信、責任、信念及知識
對於病人飲酒問題之臨床實務的影響............28
第六章 討論.......................................... 32
第七章 結論...........................................38
參考文獻...............................................42
附錄...................................................75
表一 台灣常見酒類的酒精濃度..............................58
表二 一個標準杯在各類酒精含量............................59
表三 個體血中酒精濃度及臨床症狀..........................60
表四 常用酒精篩檢量表....................................61
表五 護理人員執行病人飲酒問題之臨床實務、自信、責任、信念
及知識量表信效度....................................62
表六 統計分析方法........................................63
表七 護理人員之基本屬性..................................64
表八 護理人員之個人經驗..................................65
表九 護理人員執行病人飲酒問題之臨床實務得分分析..........66
表十 護理人員執行病人飲酒問題之自信得分分析........... ..67
表十一 護理人員執行病人飲酒問題之責任得分分析............68
表十二 護理人員執行病人飲酒問題之信念得分分析............69
表十三 護理人員執行病人飲酒問題之知識得分分析............70
表十四 基本屬性對護理人員執行病人飲酒問題之臨床實務一
覽表..............................................71
表十五 個人經驗對護理人員執行病人飲酒問題之臨床實務一
覽表..............................................72
表十六 護理人員其自信、責任、信念及知識對其執行病人飲酒
問題臨床實務一覽表................................73
表十七 護理人員其基本屬性、個人經驗、自信、責任、信念
及知識對其執行病人飲酒問題臨床實務之多元回歸分析..74

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